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[目的]分析与评价职业性氟接触人群降钙素受体基因(CTR)多态性及其与氟性骨损伤相关因素的交互作用,为氟性骨损伤干预政策及措施的制定提供理论依据。[方法]对湖北省某铝厂氟暴露工人245例进行流行病学调查和实验室检查,以右前臂和骨盆X射线正位片确定的氟性骨损伤119例作为病例组,其余126例作为对照组。检测病例组和对照组工人的CTR基因多态性、血氟(BF)、尿氟(UF)、血清骨钙素(BGP)、降钙素(CT)、碱性磷酸酶(ALP)和骨特异性碱性磷酸酶(BALP)等指标。[结果]氟暴露工人CTR基因型为CC型169例(69.0%),TC型70例(28.6%),TT型6例(2.4%);C、T等位基因频率分别为83.3%和16.7%。影响氟性骨损伤发生的独立危险因素为饮酒,UF高、BGP高、CT高、BALP高及CTR基因型(非CC型),其OR值分别为1.729,1.217,1.579,1.049,1.024和14.620。CTR T等位基因与UF存在正相加模型交互作用[交互作用超额相对危险度(RERI)=14.34(95%CI:1.47~32.16),交互作用归因比(API)=0.75(95%CI:0.50~1.00),交互作用指数(S)=4.7(95%CI:1.65~14.89)]。[结论]本次研究的结果显示饮酒,UF、BGP、CT、BALP高和CTR基因型(非CC型)是氟性骨损伤的危险因素,CTR T等位基因与UF在氟性骨损伤的发生中存在交互作用。
[Objective] To analyze and evaluate the interaction between calcitonin receptor gene (CTR) polymorphism and related factors of fluorosis bone injury in occupational fluorine exposure population and to provide a theoretical basis for the policy and measures of intervention . [Methods] The epidemiological investigation and laboratory examination of 245 fluoride exposed workers in an aluminum factory in Hubei Province were carried out. One hundred and ninety-nine cases of fluorosis-induced bone injury identified by right forearm and pelvic X-ray were selected as the cases and the remaining 126 Control group. The CTR gene polymorphisms, blood fluoride (BF), urinary fluoride (UF), serum BGP, calcitonin (CT), alkaline phosphatase (ALP) and bone Specific alkaline phosphatase (BALP) and other indicators. [Results] The CTR genotypes of workers exposed to fluorosis were 169 (69.0%) with CC, 70 (28.6%) with TC, and 6 (2.4%) with TT. The frequencies of C and T alleles were 83.3% and 16.7 %. The independent risk factors of fluorosis bone injury were alcohol consumption, high UF, high BGP, high CT, high BALP and CTR genotypes (non-CC) with ORs of 1.729,1.217,1.579,1.049,1.024 and 14.620 . The interaction between the CTR T allele and UF was positive for model interaction [RERI = 14.34 (95% CI: 1.47-32.16), interaction attribution = 0.75 (95% CI : 0.50 ~ 1.00), interaction index (S) = 4.7 (95% CI: 1.65 ~ 14.89)]. [Conclusion] The results of this study showed that alcohol consumption, UF, BGP, CT, BALP high and CTR genotype (non-CC type) were risk factors for fluorosis bone injury. The CTR T allele was associated with UF in fluorosis bone injury There is an interaction in the event.